Skip to main content
Top
Published in: Respiratory Research 1/2007

Open Access 01-12-2007 | Research

Truncated recombinant human SP-D attenuates emphysema and type II cell changes in SP-D deficient mice

Authors: Lars Knudsen, Matthias Ochs, Rosemarie MacKay, Paul Townsend, Roona Deb, Christian Mühlfeld, Joachim Richter, Fabian Gilbert, Samuel Hawgood, Kenneth Reid, Howard Clark

Published in: Respiratory Research | Issue 1/2007

Login to get access

Abstract

Background

Surfactant protein D (SP-D) deficient mice develop emphysema-like pathology associated with focal accumulations of foamy alveolar macrophages, an excess of surfactant phospholipids in the alveolar space and both hypertrophy and hyperplasia of alveolar type II cells. These findings are associated with a chronic inflammatory state. Treatment of SP-D deficient mice with a truncated recombinant fragment of human SP-D (rfhSP-D) has been shown to decrease the lipidosis and alveolar macrophage accumulation as well as production of proinflammatory chemokines. The aim of this study was to investigate if rfhSP-D treatment reduces the structural abnormalities in parenchymal architecture and type II cells characteristic of SP-D deficiency.

Methods

SP-D knock-out mice, aged 3 weeks, 6 weeks and 9 weeks were treated with rfhSP-D for 9, 6 and 3 weeks, respectively. All mice were sacrificed at age 12 weeks and compared to both PBS treated SP-D deficient and wild-type groups. Lung structure was quantified by design-based stereology at the light and electron microscopic level. Emphasis was put on quantification of emphysema, type II cell changes and intracellular surfactant. Data were analysed with two sided non-parametric Mann-Whitney U-test.

Main Results

After 3 weeks of treatment, alveolar number was higher and mean alveolar size was smaller compared to saline-treated SP-D knock-out controls. There was no significant difference concerning these indices of pulmonary emphysema within rfhSP-D treated groups. Type II cell number and size were smaller as a consequence of treatment. The total volume of lamellar bodies per type II cell and per lung was smaller after 6 weeks of treatment.

Conclusion

Treatment of SP-D deficient mice with rfhSP-D leads to a reduction in the degree of emphysema and a correction of type II cell hyperplasia and hypertrophy. This supports the concept that rfhSP-D might become a therapeutic option in diseases that are characterized by decreased SP-D levels in the lung.
Literature
1.
go back to reference Pauwels RA, Rabe KF: Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet 2004, 364:613–620.CrossRefPubMed Pauwels RA, Rabe KF: Burden and clinical features of chronic obstructive pulmonary disease (COPD). Lancet 2004, 364:613–620.CrossRefPubMed
2.
go back to reference Honda Y, Takahashi H, Kuroki Y, Akino T, Abe S: Decreased contents of surfactant proteins A and D in BAL fluids of healthy smokers. Chest 1996, 109:1006–1009.CrossRefPubMed Honda Y, Takahashi H, Kuroki Y, Akino T, Abe S: Decreased contents of surfactant proteins A and D in BAL fluids of healthy smokers. Chest 1996, 109:1006–1009.CrossRefPubMed
3.
go back to reference Betsuyaku T, Kuroki Y, Nagai K, Nasuhara Y, Nishimura M: Effects of ageing and smoking on SP-A and SP-D levels in bronchoalveolar lavage fluid. Eur Respir J 2004, 24:964–970.CrossRefPubMed Betsuyaku T, Kuroki Y, Nagai K, Nasuhara Y, Nishimura M: Effects of ageing and smoking on SP-A and SP-D levels in bronchoalveolar lavage fluid. Eur Respir J 2004, 24:964–970.CrossRefPubMed
4.
go back to reference Noah TL, Murphy PC, Alink JJ, Leigh MW, Hull WM, Stahlman MT, Whitsett JA: Bronchoalveolar lavage fluid surfactant protein-A and surfactant protein-D are inversely related to inflammation in early cystic fibrosis. Am J Respir Crit Care Med 2003, 168:685–691.CrossRefPubMed Noah TL, Murphy PC, Alink JJ, Leigh MW, Hull WM, Stahlman MT, Whitsett JA: Bronchoalveolar lavage fluid surfactant protein-A and surfactant protein-D are inversely related to inflammation in early cystic fibrosis. Am J Respir Crit Care Med 2003, 168:685–691.CrossRefPubMed
5.
go back to reference von Bredow C, Wiesener A, Griese M: Proteolysis of surfactant protein D by cystic fibrosis relevant proteases. Lung 2003, 181:79–88.CrossRefPubMed von Bredow C, Wiesener A, Griese M: Proteolysis of surfactant protein D by cystic fibrosis relevant proteases. Lung 2003, 181:79–88.CrossRefPubMed
6.
go back to reference Guo X, Lin HM, Lin Z, Montano M, Sansores R, Wang G, DiAngelo S, Pardo A, Selman M, Floros J: Surfactant protein gene A, B, and D marker alleles in chronic obstructive pulmonary disease of a Mexican population. Eur Respir J 2001, 18:482–490.CrossRefPubMed Guo X, Lin HM, Lin Z, Montano M, Sansores R, Wang G, DiAngelo S, Pardo A, Selman M, Floros J: Surfactant protein gene A, B, and D marker alleles in chronic obstructive pulmonary disease of a Mexican population. Eur Respir J 2001, 18:482–490.CrossRefPubMed
7.
go back to reference Crouch E, Wright JC: Surfactant proteins A and D and pulmonary host defense. Annu Rev Physiol 2001, 63:521–554.CrossRefPubMed Crouch E, Wright JC: Surfactant proteins A and D and pulmonary host defense. Annu Rev Physiol 2001, 63:521–554.CrossRefPubMed
8.
go back to reference Hartl D, Griese M: Surfactant protein D in human lung diseases. Eur J Clin Invest 2006, 36:423–435.CrossRefPubMed Hartl D, Griese M: Surfactant protein D in human lung diseases. Eur J Clin Invest 2006, 36:423–435.CrossRefPubMed
9.
go back to reference Ochs M, Knudsen L, Allen L, Stumbaugh A, Levitt S, Nyengaard JR, Hawgood S: GM-CSF mediates alveolar epithelial type II cell changes, but not emphysema-like pathology, in SP-D deficient mice. Am J Physiol Lung Cell Mol Physiol 2004, 287:L1333-L1341.CrossRefPubMed Ochs M, Knudsen L, Allen L, Stumbaugh A, Levitt S, Nyengaard JR, Hawgood S: GM-CSF mediates alveolar epithelial type II cell changes, but not emphysema-like pathology, in SP-D deficient mice. Am J Physiol Lung Cell Mol Physiol 2004, 287:L1333-L1341.CrossRefPubMed
10.
go back to reference Botas C, Poulain F, Akiyama J, Brown C, Allen L, Goerke J, Clements J, Carlson E, Gillespie AM, Epstein C, Hawgood S: Altered surfactant homeostasis and alveolar type II cell morphology in mice lacking surfactant protein D. Proc Natl Acad Sci USA 1998, 95:11869–11874.CrossRefPubMedPubMedCentral Botas C, Poulain F, Akiyama J, Brown C, Allen L, Goerke J, Clements J, Carlson E, Gillespie AM, Epstein C, Hawgood S: Altered surfactant homeostasis and alveolar type II cell morphology in mice lacking surfactant protein D. Proc Natl Acad Sci USA 1998, 95:11869–11874.CrossRefPubMedPubMedCentral
11.
go back to reference Clark H, Palaniyar N, Strong P, Edmondson J, Hawgood S, Reid KBM: Surfactant protein D reduces alveolar macrophage apoptosis in vivo. J Immunol 2002, 169:2892–2899.CrossRefPubMed Clark H, Palaniyar N, Strong P, Edmondson J, Hawgood S, Reid KBM: Surfactant protein D reduces alveolar macrophage apoptosis in vivo. J Immunol 2002, 169:2892–2899.CrossRefPubMed
12.
go back to reference Savill J, Fadok VA: Corpse clearance defines the meaning of cell death. Nature 2000, 407:784–788.CrossRefPubMed Savill J, Fadok VA: Corpse clearance defines the meaning of cell death. Nature 2000, 407:784–788.CrossRefPubMed
13.
go back to reference Schagat TL, Wofford JA, Wright JR: Surfactant protein A enhances alveolar macrophage phagocytosis of apoptotic neutrophils. J Immunol 2001, 166:2727–2733.CrossRefPubMed Schagat TL, Wofford JA, Wright JR: Surfactant protein A enhances alveolar macrophage phagocytosis of apoptotic neutrophils. J Immunol 2001, 166:2727–2733.CrossRefPubMed
14.
go back to reference Clark H, Palaniyar N, Hawgood S, Reid KBM: A recombinant fragment of human surfactant protein D reduces alveolar macrophage apoptosis and pro-inflammatory cytokines in mice developing pulmonary emphysema. Ann N Y Acad Sci 2003, 1010:113–116.CrossRefPubMed Clark H, Palaniyar N, Hawgood S, Reid KBM: A recombinant fragment of human surfactant protein D reduces alveolar macrophage apoptosis and pro-inflammatory cytokines in mice developing pulmonary emphysema. Ann N Y Acad Sci 2003, 1010:113–116.CrossRefPubMed
15.
go back to reference Haslett C: Granulocyte apoptosis and its role in the resolution and control of lung inflammation. Am J Respir Crit Care Med 1999,160(5 Pt 2):S5-S11.CrossRefPubMed Haslett C: Granulocyte apoptosis and its role in the resolution and control of lung inflammation. Am J Respir Crit Care Med 1999,160(5 Pt 2):S5-S11.CrossRefPubMed
16.
go back to reference Wert S, Yoshida M, LeVine AM, Ikegami M, Jones T, Ross GF, Fisher JH, Korfhagen T, Whitsett JA: Increased metalloproteinase activity, oxidant production, and emphysema in surfactant protein D gene-inactivated mice. Proc Natl Acad Sci USA 2000, 97:5972–5977.CrossRefPubMedPubMedCentral Wert S, Yoshida M, LeVine AM, Ikegami M, Jones T, Ross GF, Fisher JH, Korfhagen T, Whitsett JA: Increased metalloproteinase activity, oxidant production, and emphysema in surfactant protein D gene-inactivated mice. Proc Natl Acad Sci USA 2000, 97:5972–5977.CrossRefPubMedPubMedCentral
17.
go back to reference Yoshida M, Korfhagen TR, Whitsett JA: Surfactant protein D regulates NF-κB and matrix metalloproteinase production in alveolar macrophages via oxidant-sensitive pathways. J Immunol 2001, 166:7514–7519.CrossRefPubMed Yoshida M, Korfhagen TR, Whitsett JA: Surfactant protein D regulates NF-κB and matrix metalloproteinase production in alveolar macrophages via oxidant-sensitive pathways. J Immunol 2001, 166:7514–7519.CrossRefPubMed
19.
go back to reference Strong P, Reid KBM, Clark HW: Intranasal delivery of a truncated recombinant human SP-D is effective at down-regulating allergic hypersensitivity in mice sensitized to allergens of Aspergillus fumigatus. Clin Exp Immunol 2002, 130:19–24.CrossRefPubMedPubMedCentral Strong P, Reid KBM, Clark HW: Intranasal delivery of a truncated recombinant human SP-D is effective at down-regulating allergic hypersensitivity in mice sensitized to allergens of Aspergillus fumigatus. Clin Exp Immunol 2002, 130:19–24.CrossRefPubMedPubMedCentral
20.
go back to reference Shrive AK, Tharia HA, Strong P, Kishore U, Burns I, Rizkallah PJ, Reid KBM, Greenhough TJ: High-resolution structural insights into ligand binding and immune cell recognition by human lung surfactant protein D. J Mol Biol 2003, 331:509–523.CrossRefPubMed Shrive AK, Tharia HA, Strong P, Kishore U, Burns I, Rizkallah PJ, Reid KBM, Greenhough TJ: High-resolution structural insights into ligand binding and immune cell recognition by human lung surfactant protein D. J Mol Biol 2003, 331:509–523.CrossRefPubMed
21.
go back to reference Scherle W: A simple method for volumetry of organs in quantitative stereology. Mikroskopie 1970, 26:57–60.PubMed Scherle W: A simple method for volumetry of organs in quantitative stereology. Mikroskopie 1970, 26:57–60.PubMed
22.
go back to reference Fehrenbach H, Ochs M: Studying lung ultrastructure. In Methods in pulmonary research. Edited by: Uhlig S, Taylor AE. Basel: Birkhäuser; 1998:429–454.CrossRef Fehrenbach H, Ochs M: Studying lung ultrastructure. In Methods in pulmonary research. Edited by: Uhlig S, Taylor AE. Basel: Birkhäuser; 1998:429–454.CrossRef
23.
go back to reference Ochs M, Nyengaard JR, Jung A, Knudsen L, Voigt M, Wahlers T, Richter J, Gundersen HJG: The number of alveoli in the human lung. Am J Respir Crit Care Med 2004, 169:120–124.CrossRefPubMed Ochs M, Nyengaard JR, Jung A, Knudsen L, Voigt M, Wahlers T, Richter J, Gundersen HJG: The number of alveoli in the human lung. Am J Respir Crit Care Med 2004, 169:120–124.CrossRefPubMed
24.
go back to reference Hyde DM, Tyler NK, Putney LF, Singh P, Gundersen HJ: Total number and mean size of alveoli in mammalian lung estimated using fractionator sampling and unbiased estimates of the Euler characteristic of alveolar openings. Anat Rec A Discov Mol Cell Evol Biol 2004,277(1):216–226.CrossRefPubMed Hyde DM, Tyler NK, Putney LF, Singh P, Gundersen HJ: Total number and mean size of alveoli in mammalian lung estimated using fractionator sampling and unbiased estimates of the Euler characteristic of alveolar openings. Anat Rec A Discov Mol Cell Evol Biol 2004,277(1):216–226.CrossRefPubMed
25.
go back to reference Howard CV, Reed GM: Unbiased stereology. Three-dimensional measurement in microscopy. 2nd edition. Oxford: Bios; 2005. Howard CV, Reed GM: Unbiased stereology. Three-dimensional measurement in microscopy. 2nd edition. Oxford: Bios; 2005.
26.
go back to reference Sterio DC: The unbiased estimation of number and sizes of arbitrary particles using the disector. J Microsc 1984, 134:127–136.CrossRefPubMed Sterio DC: The unbiased estimation of number and sizes of arbitrary particles using the disector. J Microsc 1984, 134:127–136.CrossRefPubMed
27.
28.
go back to reference Gundersen HJ, Jensen EB: Stereological estimation of the volume-weighted mean volume of arbitrary particles observed on random sections. J Microsc 1985,138(Pt 2):127–142.CrossRefPubMed Gundersen HJ, Jensen EB: Stereological estimation of the volume-weighted mean volume of arbitrary particles observed on random sections. J Microsc 1985,138(Pt 2):127–142.CrossRefPubMed
29.
go back to reference Cochran WG: Sampling Techniques. 3rd edition. New York: John Wiley & Sons; Cochran WG: Sampling Techniques. 3rd edition. New York: John Wiley & Sons;
30.
go back to reference Kroustrup JP, Gundersen HJP: Sampling problems in a heterogeneous organ: quantification of relative and total volume of pancreatic islets by light microscopy. J Microsc 1983, 132:43–55.CrossRefPubMed Kroustrup JP, Gundersen HJP: Sampling problems in a heterogeneous organ: quantification of relative and total volume of pancreatic islets by light microscopy. J Microsc 1983, 132:43–55.CrossRefPubMed
31.
go back to reference LeVine AM, Whitsett JA, Hartshorn KL, Crouch EC, Korfhagen TR: Surfactant protein D enhances clearance of Influenza A virus from the lung in vivo. J Immunol 2001, 167:5868–5873.CrossRefPubMed LeVine AM, Whitsett JA, Hartshorn KL, Crouch EC, Korfhagen TR: Surfactant protein D enhances clearance of Influenza A virus from the lung in vivo. J Immunol 2001, 167:5868–5873.CrossRefPubMed
32.
go back to reference LeVine AM, Whitsett JA, Gwozdz JA, Richardson TR, Fisher JH, Burhans MS, Korfhagen TR: Distinct effects of surfactant protein A or D during bacterial infection on the lung. J Immunol 2000, 165:3934–3940.CrossRefPubMed LeVine AM, Whitsett JA, Gwozdz JA, Richardson TR, Fisher JH, Burhans MS, Korfhagen TR: Distinct effects of surfactant protein A or D during bacterial infection on the lung. J Immunol 2000, 165:3934–3940.CrossRefPubMed
33.
go back to reference Jounblat R, Clark C, Eggleton P, Hawgood S, Andrew PW, Kadioglu A: The role of surfactant protein D in the colonization of the respiratory tract and onset of bacteraemia during pneumococcal pneumonia. Respir Res 2005, 6:126.CrossRefPubMedPubMedCentral Jounblat R, Clark C, Eggleton P, Hawgood S, Andrew PW, Kadioglu A: The role of surfactant protein D in the colonization of the respiratory tract and onset of bacteraemia during pneumococcal pneumonia. Respir Res 2005, 6:126.CrossRefPubMedPubMedCentral
34.
go back to reference Kierstein S, Poulain FR, Cao Y, Grous M, Matias R, Kierstein G, Beers MF, Salmon M, Panettieri RA Jr, Haczku A: Susceptibility to ozone-induced airway inflammation is associated with decreased levels of surfactant protein D. Respir Res 2006, 7:85.CrossRefPubMedPubMedCentral Kierstein S, Poulain FR, Cao Y, Grous M, Matias R, Kierstein G, Beers MF, Salmon M, Panettieri RA Jr, Haczku A: Susceptibility to ozone-induced airway inflammation is associated with decreased levels of surfactant protein D. Respir Res 2006, 7:85.CrossRefPubMedPubMedCentral
35.
go back to reference Strong P, Townsend P, Mackay R, Reid KBM, Clark HW: A recombinant fragment of human SP-D reduces allergic responses in mice sensitized to house dust mite allergens. Clin Exp Immunol 2003, 134:181–187.CrossRefPubMedPubMedCentral Strong P, Townsend P, Mackay R, Reid KBM, Clark HW: A recombinant fragment of human SP-D reduces allergic responses in mice sensitized to house dust mite allergens. Clin Exp Immunol 2003, 134:181–187.CrossRefPubMedPubMedCentral
36.
go back to reference Ikegami M, Carter K, Bishop K, Yadav A, Masterjohn E, Brondyk W, Scheule KR, Whitsett JA: Intratracheal recombinant surfactant protein D prevents endotoxin shock in the newborn preterm lamb. Am J Respir Crit Care Med 2006, 173:1342–1347.CrossRefPubMedPubMedCentral Ikegami M, Carter K, Bishop K, Yadav A, Masterjohn E, Brondyk W, Scheule KR, Whitsett JA: Intratracheal recombinant surfactant protein D prevents endotoxin shock in the newborn preterm lamb. Am J Respir Crit Care Med 2006, 173:1342–1347.CrossRefPubMedPubMedCentral
37.
go back to reference Clark H, Reid K: The potential of recombinant surfactant protein D therapy to reduce inflammation in neonatal chronic lung disease, cystic fibrosis, and emphysema. Arch Dis Child 2003, 88:981–984.CrossRefPubMedPubMedCentral Clark H, Reid K: The potential of recombinant surfactant protein D therapy to reduce inflammation in neonatal chronic lung disease, cystic fibrosis, and emphysema. Arch Dis Child 2003, 88:981–984.CrossRefPubMedPubMedCentral
38.
go back to reference Clark H, Reid KBM: Structural requirements for SP-D function in vitro and in vivo: therapeutic potential of recombinant SP-D. Immunobiol 2002, 205:619–631.CrossRef Clark H, Reid KBM: Structural requirements for SP-D function in vitro and in vivo: therapeutic potential of recombinant SP-D. Immunobiol 2002, 205:619–631.CrossRef
39.
go back to reference Gardai SJ, Xiao Y, Dickinson M, Nick JA, Voelker DR, Greene KE, Henson PM: By binding SIRPα or calreticulin/CD91, lung collectins act as dual function surveillance molecules to suppress or enhance inflammation. Cell 2003, 115:13–23.CrossRefPubMed Gardai SJ, Xiao Y, Dickinson M, Nick JA, Voelker DR, Greene KE, Henson PM: By binding SIRPα or calreticulin/CD91, lung collectins act as dual function surveillance molecules to suppress or enhance inflammation. Cell 2003, 115:13–23.CrossRefPubMed
41.
go back to reference Zhang L, Ikegami M, Dey CR, Korfhagen TR, Whitsett JA: Reversibility of pulmonary abnormalities by conditional replacement of surfactant protein D (SP-D) in vivo. J Biol Chem 2002, 277:38709–38713.CrossRefPubMed Zhang L, Ikegami M, Dey CR, Korfhagen TR, Whitsett JA: Reversibility of pulmonary abnormalities by conditional replacement of surfactant protein D (SP-D) in vivo. J Biol Chem 2002, 277:38709–38713.CrossRefPubMed
42.
go back to reference Kingma S, Zhang L, Ikegami M, Hartshorn K, McCormack F, Whitsett JA: Correction of pulmonary abnormalities in Sftpd -/- mice requires the collagenous domain of surfactant protein D. J Biol Chem 2006, 281:24496–24505.CrossRefPubMed Kingma S, Zhang L, Ikegami M, Hartshorn K, McCormack F, Whitsett JA: Correction of pulmonary abnormalities in Sftpd -/- mice requires the collagenous domain of surfactant protein D. J Biol Chem 2006, 281:24496–24505.CrossRefPubMed
43.
go back to reference Hawgood S, Akiyama J, Brown C, Allen L, Li G, Poulain F: GM-CSF mediates alveolar macrophages proliferation and type II cell hypertrophy in SP-D gene-targeted mice. Am J Physiol Lung Cell Mol Physiol 2001, 280:L1148-L1156.PubMed Hawgood S, Akiyama J, Brown C, Allen L, Li G, Poulain F: GM-CSF mediates alveolar macrophages proliferation and type II cell hypertrophy in SP-D gene-targeted mice. Am J Physiol Lung Cell Mol Physiol 2001, 280:L1148-L1156.PubMed
44.
go back to reference Huffman Reed JA, Rice WR, Zsengellér ZK, Wert SE, Dranoff G, Whitsett JA: GM-CSF enhances lung growth and causes alveolar type II epithelial cell hyperplasia in transgenic mice. Am J Physiol 1997,273(4 Pt 1):L715-L725.PubMed Huffman Reed JA, Rice WR, Zsengellér ZK, Wert SE, Dranoff G, Whitsett JA: GM-CSF enhances lung growth and causes alveolar type II epithelial cell hyperplasia in transgenic mice. Am J Physiol 1997,273(4 Pt 1):L715-L725.PubMed
45.
go back to reference Fisher JH, Sheftelyevich V, Ho YS, Fligiel S, McCormack FX, Korfhagen TR, Whitsett JA, Ikegami M: Pulmonary-specific expression of SP-D corrects pulmonary lipid accumulation in SP-D gene-targeted mice. Am J Physiol Lung Cell Mol Physiol 2000, 278:L365-L373.PubMed Fisher JH, Sheftelyevich V, Ho YS, Fligiel S, McCormack FX, Korfhagen TR, Whitsett JA, Ikegami M: Pulmonary-specific expression of SP-D corrects pulmonary lipid accumulation in SP-D gene-targeted mice. Am J Physiol Lung Cell Mol Physiol 2000, 278:L365-L373.PubMed
Metadata
Title
Truncated recombinant human SP-D attenuates emphysema and type II cell changes in SP-D deficient mice
Authors
Lars Knudsen
Matthias Ochs
Rosemarie MacKay
Paul Townsend
Roona Deb
Christian Mühlfeld
Joachim Richter
Fabian Gilbert
Samuel Hawgood
Kenneth Reid
Howard Clark
Publication date
01-12-2007
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2007
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-8-70

Other articles of this Issue 1/2007

Respiratory Research 1/2007 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.